RESEARCH ARTICLE
Phenotype, Body Composition, and Prediction Equations (Indian Fatty Liver Index) for NonAlcoholic Fatty Liver Disease in Non-Diabetic Asian Indians: A Case-Control Study Surya Prakash Bhatt1,2,4, Anoop Misra1,3*, Priyanka Nigam1, Randeep Guleria2, M. A. Qadar Pasha4 1 Diabetic Foundation (India) and National Diabetes Obesity and Cholesterol Foundation (N-DOC), New Delhi, India, 2 Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India, 3 Fortis C-DOC Center of Excellence for Diabetes, Metabolic Diseases, and Endocrinology, B 16, Chirag Enclave, New Delhi, India, 4 Council of Scientific & Industrial Research-Institute of Genomics and Integrative Biology, Delhi, India *
[email protected]
OPEN ACCESS Citation: Bhatt SP, Misra A, Nigam P, Guleria R, Pasha MAQ (2015) Phenotype, Body Composition, and Prediction Equations (Indian Fatty Liver Index) for Non-Alcoholic Fatty Liver Disease in Non-Diabetic Asian Indians: A Case-Control Study. PLoS ONE 10 (11): e0142260. doi:10.1371/journal.pone.0142260 Editor: Kottarappat N Dileepan, University of Kansas Medical Center, UNITED STATES
Abstract Objective In this study, we have attempted comparison of detailed body composition phenotype of Asian Indians with non-alcoholic fatty liver disease (NAFLD) vs. those without, in a case controlled manner. We also aim to analyse prediction equations for NAFLD for non-diabetic Asian Indians, and compare performance of these with published prediction equations researched from other populations.
Received: July 7, 2015 Accepted: October 20, 2015
Methods
Published: November 24, 2015 Copyright: © 2015 Bhatt et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
In this case-control study, 162 cases and 173 age-and sex-matched controls were recruited. Clinical, anthropometric, metabolic, and body composition profiles, and liver ultrasound were done. Fasting insulin levels, value of homeostasis model assessment of insulin resistance (HOMA-IR), and serum high sensitive C-reactive protein (hs-CRP) levels were evaluated. Multivariate logistic and linear regression analyses were used to arrive at prediction equations for fatty liver [Indian fatty liver index (IFLI)].
Data Availability Statement: All relevant data are within the paper and its Supporting Information files.
Results
Funding: This study was fully supported by a grant from the Indian Council of Medical Research (No. 5/9/ 70/2008-RHM) Government of India. The funding agency had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests: The authors have declared that no competing interests exist.
As compared to those without fatty liver, those with fatty liver exhibited the following; Excess dorsocervical fat (‘Buffalo hump’), skin tags, xanthelasma, ‘double chin’, arcus; excess total, abdominal and subcutaneous adiposity, and high blood pressure, blood glucose, measures of insulin resistance (fasting insulin and HOMA-IR values), lipids and hs-CRP levels. Two prediction equations were developed; Clinical [Indian Fatty Liver Index-Clinical; IFLIC]: 1(double chin) +15.5 (systolic blood pressure) +13.8 (buffalo hump); and IFLI-Clinical and Biochemical (CB): serum triglycerides+12 (insulin)+1(systolic blood pressure) +18
PLOS ONE | DOI:10.1371/journal.pone.0142260 November 24, 2015
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Body Composition in Asian Indians
(buffalo hump). On ROC Curve analysis, IFLI performed better than all published prediction equations, except one.
Conclusion Non-diabetic Asian Indians with NAFLD researched by us were overweight/obese, had excess abdominal and subcutaneous fat, multiple other phenotypic markers, had higher insulin resistance, glycemia, dyslipidemia and subclinical inflammation than those without. Prediction score developed by us for NAFLD; IFLI-C and IFLI-CB, should be useful for clinicians and researchers.
Introduction Non-alcoholic fatty liver disease (NAFLD) includes a spectrum of liver disorders characterized by accumulation of hepatic fat in absence of significant alcohol consumption (
